Liposuction is the most commonly performed cosmetic procedure in the United States. The ideal candidate is physically fit and eats well-balanced meals but is unable to reduce fatty deposits that are well-localized and often seem to involve a genetic susceptibility.
Prior to the 1980′s, extensive surgery and general anesthesia were required to remove stubborn fatty deposits. Treatment was often limited to a few areas of the body, like the abdomen and buttocks. It involved significant risks and a long recovery. Safe procedures for removal of fat from the face, arms, knees, and thighs were not generally available.
In the mid 1980′s, Dr. Jeffrey Klein, a dermatologic surgeon, developed the tumescent liposuction technique, which allows liposuction to be performed under local anesthesia while minimizing blood loss and the risks of general anesthesia. Since its inception, liposuction performed with the tumescent technique has had an excellent safety profile and is rapidly becoming the treatment of choice.
Like all surgery, liposuction carries both benefits and risks. However, tumescent liposuction using local anesthesia is a remarkably safe procedure with few significant side effects. Infrequent minor complications such as skin irregularity, lumpiness, dimpling, loose skin, numbness, infections, and objectionable scarring (rare) may occur and are usually easily corrected.
Power-assisted or powered tumescent liposuction is the latest advance in fat removal. The “power” in the technique refers to the advanced instruments used to perform the surgery. Traditional liposuction is performed manually whereas power-assisted liposuction uses a mechanical cannula that efficiently removes fatty tissue with increased precision, less bruising and a faster healing time. According to medical experts and patients alike, power-assisted liposuction is a gentler technique than traditional liposuction and is preferred by patients. Dr. Byrd can advise you on the best method to meet your needs.
In women the most frequently areas treated by tumescent liposuction are the outer thighs followed by the abdomen. In men the most common area is the flank or “love handle” region. Other areas commonly treated include: the face, neck, upper arms, upper and lower abdomen, lower back, hips, thighs inner and outer, sides of the knees, and lower legs. It is uncommon to treat all of these areas at one time. If all areas were involved, weight loss may be a better option. Usually there are only a few regions that require tumescent liposuction.
In the tumescent technique, areas of excess fat are injected with a large amount of anesthetic liquid before liposuction is performed. The diluted solution usually contains a local anesthetic and a drug called epinephrine to shrink capillaries and minimize blood loss. The liquid causes the compartments of fat to become swollen and firm or “tumesced.” The expanded fat compartments allow the liposuction cannula to travel smoothly beneath the skin as the fat is removed. An elastic compression garment is then worn to help the skin contract and heal. The result is a sculpting of bulging areas into more attractive contours.
Tumescent liposuction using local anesthesia offers the benefits of fewer skin irregularities, less bleeding, reduced bruising, and a faster recovery. Tumescent liposuction is designed to be performed as an outpatient procedure. Thus, the potential complications from general anesthesia and a costly hospital stay can be avoided. In addition, since the patient is awake, he or she is able to sit or stand during the procedure, allowing the surgeon to check the status of the patient and progress of the contouring.
Liposuction is an alternative for removing localized fat deposits that do not respond to diet or exercise. Liposuction is not intended to be a substitute for weight loss; rather, it is a contouring procedure. It is best utilized in a program of exercise and optimal weight maintenance. Any person who is a candidate for traditional liposuction is also a good candidate for the tumescent technique. The best results are obtained in body areas where there is reasonable muscle tone, good skin elasticity, and fat is not excessive. In cases where there is a significant loss of tone and elasticity, the desired cosmetic results may require a combination of both liposuction and surgical skin tightening to remove the excessive loose tissue.
Tumescent Liposuction preparation requires avoiding medicines that can cause bleeding. Aspirin, Ibuprofen, and many arthritis medications interfere with platelet function and must be stopped 2 weeks before surgery. Many cold, sinus, and other medications contain these drugs and must also be stopped. Vitamin E interferes with the liver making blood clotting factors from Vitamin K. Stop taking Vitamin E at least 3-4 weeks before surgery. Cigarette smoking can hinder wound healing, so please stop at least 2 weeks before your operation.
To avoid ingrown hairs, don’t shave or remove hair near the regions to be sculpted the day of surgery. You cannot eat after midnight so you will arrive with an empty stomach. You will be able to take your medications with a small sip of water that morning. Check with us about any medications that you will be taking. Wear loose fitting clothing that opens in the front or pulls over easily. This will make it easier to get dressed over your pressure garment and dressings.
Before surgery, a complete medical history is taken and a physical examination is conducted in order to evaluate the body’s condition. During the consultation, Dr. Byrd describes the procedure and what results should be expected. Alternative treatment options, the possible risks and complications that may occur will be explained. Photographs are taken before and after surgery.
The anesthetic contained in the solution combined with sedation may provide sufficient comfort during the procedure. Or, if Dr. Byrd feels it is appropriate, the tumescent solution itself may serve as the sole means of anesthesia.
The local anesthesia injected into the tissue remains for about 24 hours following liposuction surgery, greatly minimizing post-operative pain. After tumescent liposuction, most patients are generally alert and able to function without the nausea, grogginess, and the washed out feeling associated with general anesthesia. In fact, patients are encouraged to walk immediately after surgery to enhance the healing process. You may weigh more, about the same, or less right after surgery. Some of this is from the extra fluid used during the tumescent technique that you will urinate over the next day or so. Some weight will be from the fluid of tissue swelling. How much and where depends on what was done. Since there is less bruising and bleeding from Tumescent Liposuction, there is less blood to be absorbed and irritate tissues. The lack of this irritation means that the swelling goes down much faster. Patients can usually return to a desk-type job within a few days. Physical exercise may be resumed three to seven days after the procedure.
You will need to limit your activity for the first couple of days – no strenuous exercise, lifting or bending over. Avoid any type of aerobic exercise (any activity that raises your pulse above 90) for at least three weeks. That much work may increase your swelling. Many are able to return to work almost immediately. It depends on what you do and the activity level of your job. Resumption of activities also depends on the extent of your Tumescent Liposuction, your health, and how you heal. In general, the discomfort lessens significantly in 2-4 days. Stabilizing your tissues in a special garment increases your comfort and ability to get around.
Your tissues will be more comfortable after Tumescent Liposuction when they are not jiggling around. Compression also helps control swelling and bruising. Our patients wear this for about two weeks full time and then part time for a third week. Different styles are available for the various zones treated by the Tumescent Liposuction. We help fit our patients in an elastic garment specially designed for this surgery. Girdle-like pants is used for the buttocks and thighs. An elastic vest is used for the male chest. Hooks and zippers on side openings assist in getting the garments on and taking them off.
Patients are usually able to see a noticeable difference almost immediately after surgery. However, more improvement can be seen after three weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling will disappear and the final contour will be visible
Tumescent Liposuction removes fat cells from localized parts of the body. Some cells are left behind intentionally. If too much fat is removed, the skin will stick unnaturally to the underlying muscle and tissues. The remaining fat cells can still store unused energy. For those who eat more than they use through exercise, the extra energy will be put away as fat. The distribution of where you put on the fat may be different after Tumescent Liposuction surgery.
Cellulite is a condition that gives the skin a rippled, dimpled appearance. Tumescent Liposuction is not an effective treatment for cellulite. Liposhifting has been found to be the most effective way of removing cellulite.
Irregularities from cellulite or previous liposuction defects can now be treated with a new development called liposhifting. This procedure allows for fat transfer without ever removing the fat from the body by utilizing new instrumentation from Buenos Aires, Argentina called a Micro Graft Fat Cutter, or MGFC. This specially designed cannula is used to break up sub-dermal scarring and shift fat around to fill in existing defects. Once the procedure is completed, the area is taped in a way to prevent migration of the newly transferred fat cells. This ensures a smooth contour once the healing takes place. Typically, only one procedure is necessary. Liposhifting is performed under local tumescent anesthesia which results in very minimal pain or bruising. Downtime is usually one to two days.
See more liposuction photos for arms, trunk and torso, lower body and neck and jowls. Links open in a new window.
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Dr. Marcia Byrd has spent over 20 years in her medical practice fine tuning her philosophy and approach to body sculpting, facial rejuvenation, weight loss, weight maintenance, and anti-aging techniques. She believes it is important to stay abreast of all the newest and latest available technological advances in cosmetic procedures but only offers those that she feels will give the best outcomes for her patients.
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